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Compliance assessment regarding the PVC management on normal wards of a university hospital
Volha Rusinovich1, Yury Rusinovich2, Iris F Chaberny1
1Institute of Hygiene, Hospital Epidemiology and Environmental Health, University of Leipzig Medical, Germany.
Insights
Peripheral venous catheter (PVC) infections are a risk, but compliance with care guidelines improved after implementing a standardized checklist and feedback system. Healthcare providers were aware of guidelines but faced time constraints in implementation.
Area of Science:
- Infection Prevention and Control
- Healthcare Quality Improvement
- Medical Device Management
Background:
- Peripheral venous catheters (PVCs) pose an underestimated infection risk in inpatients, despite lower rates than central venous catheters.
- Existing guidelines address evidence-based management of PVCs to prevent associated infections.
Purpose of the Study:
- To develop standardized methods for assessing compliance with PVC management protocols.
- To evaluate healthcare providers' self-reported knowledge and implementation of PVC care practices.
Main Methods:
- A checklist, based on Robert Koch Institute (KRINKO) recommendations, was developed to evaluate PVC management (puncture site, bandage, extension set, plug, documentation).
- The checklist was applied in 14 wards in 2019 and again in 2020 after staff feedback.
- A PVC-quality index was used for data analysis, followed by an anonymous survey of healthcare providers.
Main Results:
- Significant improvements in compliance were observed for extension set presence (p=0.049) and documentation (p<0.001) in the second year.
- The PVC-quality index increased in 12 out of 14 wards; awareness of in-house infection prevention standards was high (mean score 4.98/7).
- The primary barrier to implementing preventive measures was the time factor, with greater awareness of PVC placement than care.
Conclusions:
- The PVC quality index is a valuable tool for assessing compliance in daily practice.
- Feedback on compliance assessment improves PVC management, although outcomes can be heterogeneous.
Objective:
The risk of peripheral venous catheter (PVC) infections in inpatients is often underestimated, even if it is lower than that for central venous catheters. Guidelines for the prevention of PVC-associated infections describe the evidence-based management of PVCs. The aims of this study were the development of standardized methods for compliance assessment regarding PVC management and the evaluation of self-reported knowledge and implementations among healthcare providers regarding PVC care.
Method:
We developed a checklist based on the recommendation of the Commission of Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO) Berlin for the standardized evaluation of PVC management. The following parameters were collected and evaluated: condition of the puncture site, condition of the bandage, presence of an extension set, presence of a plug, and documentation. The checklist was applied in 14 normal wards in 2019. After feedback of the ward staff on the results, it was applied again in 2020 in the same wards. For retrospective data analysis, we used a newly developed PVC-quality index. After the second evaluation in 2020, we carried out an anonymous survey among the healthcare providers.
Results:
The evaluation of 627 indwelling PVCs showed a significant increase in compliance related to the presence of an extension set (p=0.049) and documentation (p<0.001) in the 2nd year. The quality index increased in 12 out of 14 wards. The participants of the survey were aware of the in-house standard "Prevention of vascular catheter-associated infections", with a mean score of 4.98 on a Likert scale (1=not aware, 7=completely aware). The main barrier to implementation of the preventive measures was the time factor. Survey participants were more aware of PVC placement than PVC care.
Conclusion:
The PVC quality index is a valuable tool for the assessment of compliance regarding PVC management in daily practice. Feedback from the ward staff on the results of compliance assessment improves PVC management, but the outcome is very heterogeneous.
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